The following information details health insurance and assistance programs available to uninsured people in West Virginia.
West Virginia Insurance Commission - (888) 879-9842
In West Virginia, state law allows health insurance companies to turn people down for individual health insurance coverage based on the status of their health. In most cases, diabetes is considered an “uninsurable” condition. Even though you can be turned down for an individual policy in West Virginia, you can never be turned down for health insurance that is offered through an employer.
If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Insurance Commission. They may be able to provide you with assistance in reaching a conclusion.
West Virginia Small Business Plan- (888) 558-7002
The West Virginia Small Business Plan helps make company-sponsored health insurance more affordable. It is a unique private/public partnership combining the strengths of participating insurance companies and state government to create lower cost, yet comprehensive, health coverage policies.
To qualify, a business must:
-Have 2-50 employees
-Have been without a company-sponsored health insurance plan for a minimum of 12 consecutive months
-Been in operation for at least one year
-Have a minimym of 75 percent eligible employees willing to sign up for the plan
-Be willing to pay at least 50 percent of the cost of individual coverage
West Virginia Medicaid - (800) 642-8589
Medicaid is available to anyone who meets income and eligibility criteria. Even if your income meets the criteria, you must fall into one of the eligibility categories in order to qualify. Contact your state Medicaid program for more information.
West Virginia Children’s Health Insurance Program - State Children’s Health Insurance Program - (877) 982-2447
The West Virginia Children’s Health Insurance Program is the health insurance program designed to provide health insurance to children and teens under age 19 whose families may have too great an income to qualify for Medicaid, but who may not be able to afford health insurance. Visit the Web site to find out if you or your child meets the income requirements.
AccessWV - (866) 445-8491
Access WV is the West Virginia high-risk pool. This program allows individual health insurance policies to be sold to people who might otherwise be considered “uninsurable” because of a chronic illness like diabetes. Premiums may be high, and/or a pre-existing condition waiting period may apply. Contact AccessWV for more information.
Pre-Existing Condition Insurance Plan (PCIP)
Through the Affordable Care Act, uninsured people with diabetes who have been continually uninsured for six months or more will be able to access insurance through a new program called the Pre-Existing Condition Insurance Plan (PCIP). PCIP, which is administered by either your state or the U.S. Department of Health and Human Services, will be available until the provisions banning discrimination based on pre-existing conditions are fully implemented in 2014.
PCIP will be available in every state, but the program may vary depending on the state. Currently, many states run programs, often called “high risk pools,” to offer insurance for those with pre-existing conditions. To build on what states are already doing, states can either run a new program with resources from the Affordable Care Act or rely on the U.S. Department of Health and Human Services to provide coverage. Please check out the State Plans page to learn more about how PCIP works in your state. https://www.pcip.gov/PCIP_States.html
Local Community Health Clinics
If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free to patients or require a very small fee. Find a clinic in your area.
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